Provider Demographics
NPI:1710746102
Name:THREE PILLARS SENIOR HOME CARE LLC
Entity Type:Organization
Organization Name:THREE PILLARS SENIOR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-277-1062
Mailing Address - Street 1:11936 PENNY BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-6886
Mailing Address - Country:US
Mailing Address - Phone:804-277-1062
Mailing Address - Fax:
Practice Address - Street 1:11936 PENNY BRIDGE DR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-6886
Practice Address - Country:US
Practice Address - Phone:804-277-1062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care